Four in ten patients suffering 'mini-strokes' do not get treatment in time

Thousands of patients are being put at risk of major strokes because the NHS is failing to give them critical surgery in time, a national audit reveals.

Research by the Royal College of Surgeons shows more than four in 10 patients who suffer from a “mini-stroke" are not being given vital treatment within the two weeks recommended.

At some trusts, those in need of urgent surgery are being forced to wait an average of almost two months, the study shows.

Charities last night said the variations across the country were “alarming” and fuelling up to 10,000 needless strokes annually.

'We are deeply concerned to see that, across the country, mini-stroke patients face lengthy delays for vital treatment, with several hospital units not meeting the two week recommended time frame for surgery'Alexis Wieroniey, deputy director of policy at the Stroke Association

Every year around 50,000 people in the UK suffer from a transient ischaemic attack (TIA).

The episodes - also known as “mini-strokes” - can cause temporary facial weakness, pins and needles and speech problems.

Guidance from the National Institute of Health and Care Excellence says the operation - known as a Carotid Endarterectomy - should take place within two weeks of a patient suffering symptoms.

But an audit of 4,250 patients across England and Wales who suffered mini-strokes in 2015 found that 43 per cent were forced to wait longer.

Smoking raises the risk of suffering a strokeCredit:
Alamy

The Royal College today called for urgent action by hospitals to stop patients being left to suffer "devastating consequences” which might easily have been avoided.

The National Vascular Registry found that on average, patients waited 13 days for surgery, against the 14-day target.

But at many trusts waiting times soared far higher, with 10 specialist units having average waiting times exceeding three weeks for the time-sensitive operations.

'It is so important that people are aware of the signs of a stroke which include blurred vision, slurred speech and weakness in the arms, legs or face'Professor Ian Loftus, consultant vascular surgeon,

Overall, average waits at specialist units ranged from six days to 55 days.

The surgical procedure involves removing plaque that has built-up in the carotid artery in the front of the neck. This prevents a further potential blockage of blood flowing to the brain – and a major stroke.

Professor Ian Loftus, a Consultant Vascular Surgeon, and lead clinician for the National Vascular Registry (NVR), said hospitals who were forcing patients to endure long waits must urgently change their ways.

He told the Telegraph: “It is vital that patients who have a mini stroke or TIA, have rapid access to specialist vascular services so a swift decision can be made as to whether or not they should have surgery.

"Hospitals with longer times for diagnosis of carotid endarterectomy must review their practice to identify how these times can be reduced."

Prof Loftus said the public also needed to know more about signs of mini-strokes, to ensure that those who suffer them received potentially life-saving treatment.

“The symptoms of a mini stroke and stroke are the same, but the difference with a mini stroke is that the patient does not suffer permanent damage. This is why it is so important that people are aware of the signs of a stroke which include blurred vision, slurred speech and weakness in the arms, legs or face.”

The study found 75 per cent of those undergoing surgery were over the age of 65, while 68 per cent were male.

The research also warns of long waits for surgery to repair abdominal aortic aneurysms (AAA) - an enlargement of the aorta, with a risk of rupture and death.

The condition causes more than 6,000 deaths a year.

National medical guidance says planned operations should take place within eight weeks of referral.

But average waits are now 65 days - and thousands of patients are waiting far longer, the audit shows.

At 28 of 78 vascular units performing planned AAA repair, one quarter of patients waited at least four months, the research found.

Alexis Wieroniey, deputy director of policy at the Stroke Association said, “A TIA or mini-stroke is a major warning sign that a person is at risk of a more severe stroke. All strokes, including TIAs or mini-stroke should be treated as an emergency. By spotting the symptoms early and having swift access to specialist services, thousands of people each year could avoid the devastating consequences of a stroke.

“We estimate that, around 10,000 strokes could be prevented each year if mini-strokes are treated in time.”

“We are deeply concerned to see that, across the country, mini-stroke patients face lengthy delays for vital treatment, with several hospital units not meeting the two week recommended time frame for surgery.”

Speedy treatment of those suffering mini-strokes could reduce the risk of a full stroke by 80 per cent, she said.

“We urgently need the Government to introduce a new stroke strategy to put an end to this alarming variation in stroke care, and ensure that people have access to the urgent treatment they need, no matter the severity of their stroke, or where they live.”

An NHS England Spokesperson said: “NHS stroke care has improved dramatically in recent years, including for those suffering mini strokes. Patients needing preventative surgery are receiving this quicker than ever before with 57 per cent receiving the surgery within the two week target time compared to only 13 per cent in 2009.

"Survival rates are at a record high but there are still further gains to be made and we are working closely with hospitals and others to further speed up time from when symptoms first show to surgery.”